May 2013, Vol.11, No.3229Journal of Integrative Medicine

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1 Introduction

As the Journal of Chinese Integrative Medicine transitions to a completely English language journal, there are likely to be challenges for authors, reviewers and editors, many of whom come to English as a second language. As one strategy to lessen the burden on stakeholders as we move to an all English publication, this article seeks to define the challenges of learning biomedical English and presents some ideas on how to acquire fluency more effectively. In this article, we make specific references to the language of acupuncture. However, the general principles probably apply to acquiring fluency in the languages of all areas of integrative medicine.

2 Biomedical language is a second language for all of us

The first principle that we would like to establish is that biomedical English is vastly different from general English – so much so that linguists have proposed the term “biomedical language” rather than biomedical English[1]. This distinction is based on the observation that the vocabulary of biomedicine and health is incomprehensible to the average native English speaker. Additionally, there are conventions of grammar, phraseology and discourse which are also quite different[2]. Consequently, the average native English speaker has little advantage over the average, for example, native Chinese speaker when trying to become fluent in the languages of biomedicine and health. In other words, biomedical language is a second language for all of us.

3 Learn the vocabulary that you really need

Fluency in any language, including biomedical language depends heavily upon acquiring an adequate vocabulary[3,4]. Furthermore, it is clearly impossible to master the complete vocabulary of biomedicine and health — that lexicon is enormous and growing constantly. Therefore, it is essential to identify, and then acquire the vocabulary which is most useful, i.e., the vocabulary of the language community in which we work. As an example of this, we will take a look at the language needed to communicate within the academic community of acupuncture.

How many words (and which words) do we really need to know in order to have functional fluency in the language of acupuncture? The short answer is quite encouraging — fewer words than we need for functional fluency in general English! It is generally accepted that in order to have functional ability to read general English, one needs to know approximately 15 000 words. This gives us the ability to read and understand, on average, 95% of the words in any text written in general English[5,6]. However, 15 000 words is far more words than most non-native English speakers ever manage to acquire. Fortunately, the demands for reading within a specialty, such as acupuncture or herbal medicine, are likely much less.

Research has shown that in order to read fluidly within a specialty in health one needs to understand at least 95% of the words on a page of text. To achieve this, one needs to master the General Service List (GSL), the approximately 2 000 most common words in the English language[7], the Academic Word List (AWL), the approximately 570 word

● Methodology

The language of integrative medicineBrian Stephen BudgellCanadian Memorial Chiropractic College, Toronto, Ontario Canada M2H 3J1

ABSTRACT: Biomedical language, also known as biomedical English, is sufficiently different from general English to warrant treatment as a distinct language. Biomedical language has its ownconventionsofgrammar,phraseologyanddiscourse,aswellasalexiconwhichiscomplexand esoteric. Furthermore, each sub-discipline, such as integrative medicine, has a unique vocabularywhichmustbemasteredinordertoachievefluency. Inthisarticle, thevocabularyspecific to acupuncture is identified, and strategies are introduced to master the use of that vocabulary. KEYWORDS: integrative medicine; acupuncture; linguistics; information retrieval

DOI: 10.3736/jintegrmed2013026Budgell BS. The language of integrative medicine. J Integr Med. 2013; 11(3): 229-232.Received December 25, 2012; accepted March 18, 2013.Open-access article copyright © 2013 Brian Stephen Budgell. Correspondence: Brian Stephen Budgell; E-mail: bbudgell@cmcc.ca

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families commonly encountered in academic settings[8] and approximately 1 000 words which are specific to our specialty of interest[9]. This is an achievable goal!

The GSL actually forms the basis for language instruction in English primary schools, and, if you studied English as a second language, was probably the basis for your early English training. This means that you probably already understand almost all of these words quite well. Because the list has undergone a few revisions since its original publication in 1953, you may find slightly different versions when you search the internet. One useful version, especially for Chinese students, can be found here: http://www2.elc.polyu.edu.hk/cill/generalServiceList.htm. This version provides access to Chinese translations, and also provides examples of each word used in English sentences.

Once we have mastered the GSL, the next step is to master the AWL. The AWL was first published in the year 2000 and so it is quite up-to-date. It focuses on words, beyond the GSL, which occur commonly in academic contexts. The AWL is often used in developing language training materials and tests such as TOEFL and IELTS. Therefore, if you already studied for one of these tests or to enter an overseas school, you have probably already learned many of the words on this list.

The complete AWL can be downloaded as a pdf file at http://www.victoria.ac.nz/lals/resources/academicwordlist/publications/awlsublists1.pdf.

The third step in acquiring our essential vocabulary is to learn the approximately 1 000 technical terms of our specialty – the most common words of our specialty other than those already covered by the GSL and the AWL. How do we identify these essential technical words? In the past, we might have relied on the opinions of experts, but these days we use the methods of corpus linguistics.

More specifically, one creates and analyzes a corpus — a large electronic collection of samples of literature which are representative of the field. In the case of acupuncture, through the Centre for Biomedical and Health Linguistics (www.bmhlinguistics.org), we have gathered 371 articles on acupuncture research published in peer-reviewed journals between 2005 and 2008. This amounted to approximately 1 127 000 words. Using the computer program Word-Smith Tools V5.0, we conducted a statistical comparison of this corpus and a corpus of general English, identifying those words which occurred significantly more often in the acupuncture literature than in general English. The list of the 2 000 most common “acupuncture keywords” can be downloaded as an Excel document entitled “acupuncture keyword list” from this address: http://www.bmhlinguistics.org/joomla2/work-lists.

This list includes GSL and AWL words, and so actually there are only about 1 000 technical words (non-GSL, non-AWL words) on this list. Altogether, these 1 000 acupuncture terms, plus the GSL and the AWL give approximately 95% coverage of the acupuncture literature — our first target for literacy. Consequently, the best advice we could give to someone who wished to become fluent in the language of acupuncture would be to first study the list of acupuncture keywords referenced above.

Authors, editors and reviewers will also want to know how these keywords should be used properly in context. In other words, we would like to see these words used in authentic sentences from the peer-reviewed literature. As examples, as authors we might wonder if we are using the word “needling” or the phrase “superficial needling” correctly in our writing. The Centre for Biomedical and Health Linguistics has an online tool, called a concordancer, which allows us to enter search phrases and see authentic sample sentences from our acupuncture corpus.

To use this tool, navigate through the front page of the Centre (www.bmhlinguistics.org) or jump directly to the concordancer at this address: http://cqpweb.wetware.ca/.

If we click on, for example, the link to “Acupuncture” at the top of the page, we are asked to log in. This can be done using the user name “betaguest1” and the password “bmhling” (Figure 1). We can then enter our search term, such as “needling” or “superficial needling” (Figure 2) and when we click on “Start Query” the system returns our set of sample sentences. In the case of “needling” the corpus provides almost 700 examples, and for “superficial needling” 36 examples. Furthermore, by using our mouse to hover over the keyword in the sample sentences, we can reveal a grammatical analysis – i.e., the part of speech of each word in the sample sentence (Figure 3).

The concordancer, called CQPWeb, is capable of other sophisticated analyses of language, but these are probably more useful to language teachers and researchers. For those of us who write or edit, just seeing authentic examples of usage will answer our question of whether we (or others) are using words properly.

Thus, we have seen that acquiring the vocabulary to read and write about acupuncture at the academic level is feasible. We need to learn the words of the GSL, the AWL and (to begin with) the approximately 1 000 most common technical terms specific to acupuncture. Furthermore, we have seen how to check, using a concordancer, to determine whether our usage is correct or conventional. With this knowledge, we are now equipped to address higher level challenges, including the creation of convincing discourse.

4 Acknowledgements

The work was supported in part by research funds from Canadian Memorial Chiropractic College.

5 Competing interests

The author declares that he has no competing interests.

REFERENCES

1 Budgell B, Miyazaki M, O'Brien M, Perkins R, Tanaka Y. Our shared biomedical language. In: International Medical Education Conference. Kuala Lumpur: International Medical University. 2007: A17.

2 Millar N, Budgell B, Fuller K. “Use the active voice whenever possible”: The impact of style-guidelines in medical journals. Appl Linguist. First published online: October 31, 2012.

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Figure 1 The CQPWeb login page provides access to a number of corpora, including the corpus of acupuncture (users may login with the username “betaguest1” and the password “bmhling”)

Figure 2 The “standard query” interface for the acupuncture corpusUsers may enter a search term in the query box and then click on “start query” to search for sentences containing the search term. The menu on the left hand side of the window also provides access to more advanced search functions.

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3 Flowerdew J. Definitions in science lectures. Appl Linguist. 1992; 13(2): 202-221.

4 Chung TM, Nation P. Identifying technical vocabulary. System. 2004; 32(2): 251-263.

5 Hirsch D, Nation P. What vocabulary size is needed to read unsimplified texts for pleasure? Reading in a Foreign Language. 1992; 8(2): 689-696.

6 Laufer B. How much lexis is necessary for reading com-prehension? In: Arnaud PJL, Béjoint H. Vocabulary and applied linguistics. London: Macmillan Academic and Pro-

fessional. 1992: 126-132.7 West MP. A general service list of English words with

semantic frequencies and a supplementary word-list for the writing of popular science and technology. London: Longmans Green. 1953.

8 Coxhead A. A new academic word list. TESOL Q. 2000; 34(2): 213-238.

9 Chiba Y, Millar N, Budgell B. The language of midwifery and perinatal care: a quantitative analysis. J Jpn Acad Midwif. 2010; 24(1): 74-83.

Submission Guide

Journal of Integrative Medicine (JIM) is a PubMed-indexed, peer-reviewed, open-access journal, publishing papers on all aspects of integrative medicine, such as acupuncture and traditional Chinese medicine, Ayurvedic medicine, herbal medicine, homeopathy, nutrition, chiropractic, mind-body medicine, Taichi, Qigong, meditation, and any other modalities of complementary and alternative medicine (CAM). Article

types include reviews, systematic reviews and meta-analyses, randomized controlled and pragmatic trials, translational and patient-centered effectiveness outcome studies, case series and reports, clinical trial protocols, preclinical and basic science studies, papers on methodology and CAM history or education, editorials, global views, commentaries, short communications, book reviews, conference proceedings, and letters to the editor.

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Figure 3 The results of a standard search using the search term “needling”By using the mouse to hover over the search term within a sentence, a grammatical analysis of the sentence is revealed.